Clinical findings and therapeutic results in cases of endocrinologically-investigated infertility with ovulatory cycles
Abrahamsson, L.; Hackl, H.; Lindström, B.; Orstam, S.; Tyreman, N.O.
Wiener Klinische Wochenschrift 92(10): 351-356
1980
ISSN/ISBN: 0043-5325 PMID: 7395222 Document Number: 154787
Plasma progesterone, LH [luteinizing hormone, lutropin], FSH [follicle-stimulating hormone, follitropin] and the low polar estrogens (estradiol + estrone) and hormonal profile in a 24 h urine collection were determined at the peak luteal phase in 99 infertile women with ovulatory cycles. A curettage with subsequent histological dating of the secretion phase endometrium was carried out at the same time and, on a smaller scale, the activity of malate and succinate dehydrogenase was determined in the endometrium. All lowered progesterone values were followed up by plasma prolactin determinations. In > 50% of cases, the low polar estrogens were reduced and in .apprx. 20%, the plasma progesterone was similarly lowered. These 2 deficiencies were combined in 11 cases. Lowered estrogen values occurred more commonly < 30 years of age and were combined with only a few other pathological findings. These lowered estrogen values are probably not of clinical significance. At > 30 yr of age, low estrogen values were frequently combined with lowered plasma progesterone and low enzymatic activity in the endometrium. These last findings seem to have greater clinical significance. Of 12 patients with a shortened luteal phase (< 11 days), lowered plasma progesterone occurred in 1 case. Lowered estrogen and progesterone values were commonly combined with normal LH and FSH values. Raised plasma prolactin values in combination with lowered progesterone values were found in 3 cases. To assess the incidence of pregnancy, 62 cases were selected for further study. The hormonal treatment given was conventional. Pregnancy occurred in 32 patients after an average treatment period of .apprx. 6 mo. In 16 cases, the treatment was not successful after an average period of 13 mo. The remaining 14 patients became pregnant without any treatment within 1 yr. For all these selected cases, the pathological findings are analyzed with regard to the occurrence or non-occurrence of pregnancy and discussed with reference to the unselected total case material.